International Braz J Urol最新文献

{"title":"Single-Port Robot-Assisted Post-Chemotherapy Unilateral Retroperitoneal Lymph Node Dissection: Feasibility and Surgical Considerations","authors":"Sisto Perdonà, Alessandro Izzo, Roberto Contieri, Francesco Passaro, Savio Domenico Pandolfo, Roberto Corrado, Giovanna Canfora, Rocco Damiano, Riccardo Autorino, Gianluca Spena","doi":"10.1590/S1677-5538.IBJU.2025.0091","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0091","url":null,"abstract":"<p><strong>Introduction: </strong>Retroperitoneal lymph node dissection (RPLND) is indicated for testicular cancer patients with residual masses post-chemotherapy or stage I-II non-seminomatous germ cell tumors (NSGCT) (1, 2). Open RPLND remains the standard but carries significant morbidity. The laparoscopic approach, while minimally invasive, presents notable technical challenges (3). Robotic-assisted RPLND (rRPLND) offers a minimally invasive alternative with comparable oncological outcomes (4, 5). The Da Vinci Single Port (SP) system presents new possibilities for reducing surgical morbidity (6, 7).</p><p><strong>Methods: </strong>We report a case of SP-rRPLND using a unilateral modified template and a lower anterior access (LAA) in a 41-year-old man with NSGCT (pT2, UICC Stage IB) who underwent left orchiectomy, followed by adjuvant chemotherapy. A CT scan revealed a 3.5 cm residual retroperitoneal mass in the left hilar region. The surgical procedure, performed with the Da Vinci SP system, involved a 2.5 cm McBurney incision for retroperitoneal access. Instrument configuration followed a \"Camera below\" setting. The unilateral left-sided modified template guided dissection from the aortic bifurcation to the renal hilum, preserving vascular structures. A 3,5 cm residual mass and para-aortic nodes were excised with the help of flexible Greena® applicator for clips.</p><p><strong>Results: </strong>Anesthetic management prioritized opioid-sparing techniques to enhance recovery. The patient received regional anesthesia, multimodal analgesia, and had an NRS pain score of 0 at discharge. The console time was 79 minutes, with minimal blood loss and no complications. The patient resumed oral intake on postoperative day 1 and was discharged on day 2. Postoperative recovery was uneventful, with no complications or need for conversion to open or laparoscopic surgery. Final histopathological examination revealed a germ cell tumor with features suggestive of immature teratoma, along with over 10 lymph nodes showing sinus histiocytosis. At six months post-RPLND, the patient remains disease-free, with a good general condition and no new symptoms. Tumor markers (AFP, β-hCG, LDH) are within normal limits, and CT imaging shows no evidence of recurrence or residual retroperitoneal masses. Renal function and hormonal profile are stable. Given prior chemotherapy exposure, cardiovascular monitoring is advised. Follow-up will continue with clinical exams and tumor markers every 3-4 months, with the next CT scan planned at 12 months, unless symptoms warrant earlier imaging.</p><p><strong>Conclusions: </strong>As far as we know this is the first reported case of SP-rRPLND in Europe. The LAA provides safe access while minimizing morbidity, potentially improving recovery (8). A unilateral approach, avoiding transperitoneal access, may further reduce morbidity (9). Future studies should validate long-term oncological outcomes and compare SP-rRPLND with multiport and ope","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Small Renal Masses: Literature and Guidelines Review.","authors":"Antonio Silvestri, Filippo Gavi, Maria Chiara Sighinolfi, Simone Assumma, Enrico Panio, Daniele Fettucciari, Giuseppe Pallotta, Or Schubert, Cristina Carerj, Mauro Ragonese, Pierluigi Russo, Riccardo Bientinesi, Nazario Foschi, Chiara Ciccarese, Roberto Iacovelli, Bernardo Rocco","doi":"10.1590/S1677-5538.IBJU.2025.0203","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0203","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) ranks among the most prevalent malignancies worldwide, with a rising incidence attributed largely to the incidental detection of small renal masses (SRMs ≤ 4 cm) through widespread abdominal imaging. Historically managed with radical nephrectomy, treatment of SRMs has evolved significantly over recent decades. Partial nephrectomy has become the standard surgical approach, while active surveillance (AS) has emerged as a viable alternative for select patients, particularly those with comorbidities or limited life expectancy. AS involves serial imaging to monitor tumor progression, reserving intervention for signs of clinical advancement. This review synthesizes oncological outcomes and current management strategies for SRMs, comparing AS with immediate intervention. A comprehensive literature search (2005-2024) was performed across PubMed, Web of Science, and Scopus, complemented by an analysis of major international guidelines (EAU, AUA, ESMO, CUA, and Latin American Renal Cancer Group). All guidelines support AS for selected patients with cT1a tumors, though criteria vary. The AUA limits AS to tumors <2 cm, while only its guidelines define clear triggers for transitioning from AS to treatment. Imaging surveillance intervals and biopsy indications also differ, with broader support for renal mass biopsy prior to ablation but more selective use during AS. This review underscores the importance of individualized decision-making in SRM management and highlights areas of consensus and divergence among contemporary guidelines.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and optimization of chronic renal insufficiency in the setting of kidney cancer A Systematic Review.","authors":"Jessica K Cobb, Hiroko Miyagi, Jad Chahoud, Claude Bassil, Philippe E Spiess","doi":"10.1590/S1677-5538.IBJU.2025.0303","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0303","url":null,"abstract":"<p><strong>Purpose: </strong>There is a bidirectional relationship between chronic kidney disease and the incidence of renal cell carcinoma. Despite the frequency of patients with both chronic kidney disease and renal cell carcinoma, there are limited systematic reviews detailing the nuanced treatment. This review provides comprehensive insights for clinicians for managing chronic kidney disease, and renal cell carcinoma. Methods and Methods: We reviewed published literature that examined either chronic kidney disease and renal cell carcinoma or an indirect contributor of both.</p><p><strong>Results: </strong>We compare and contrast renal cell carcinoma treatment with partial and radical nephrectomies, ablative techniques, and radiation and their impact on glomerular filtration rate, recurrence rate, and contraindications. We discuss when and how to intervene with treatment with emphasis on the delicate balance between eradicating malignancy and preserving renal function. Specifically, we detail the appropriate use of renal biopsies in incidentally discovered tumors, active surveillance, and postoperative surveillance including imaging sensitivity and specificity. We offer insight into the limitations of current systemic therapy, including renal toxicity.</p><p><strong>Conclusions: </strong>Our investigation into the intricate relationship between chronic kidney disease and renal cell carcinoma has many multifaceted challenges for both patients and healthcare providers face. This comprehensive review serves as an extensive synopsis of the current literature and offers patients the best possible long-term renal-based outcomes.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial.","authors":"Melissa Faria Dutra, Eleonora Moreira Lima, José Bastos Murillo, Lidyanne Ilídia da Silva de Paula, José de Bessa, Amanda Lima Alves Pereira, Glaúcia Cristina Medeiros Dias, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad","doi":"10.1590/S1677-5538.IBJU.2025.0093","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0093","url":null,"abstract":"<p><strong>Purpose: </strong>Approximately one-third of the children with primary monosymptomatic enuresis (PMNE) do not respond to first-line treatment. We aimed to investigate the short-term and six-month effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS) in these children and adolescents.</p><p><strong>Materials and methods: </strong>Participants aged six-17 years with PMNE were randomly assigned to receive desmopressin acetate with active or sham PTENS. Both groups participated in weekly 30-minute electrotherapy sessions for 15 weeks. The intervention group (IG) received electrotherapy at a frequency of 10 Hz and pulse width of 700 µs. A dry and wet nights calendar assessed the frequency of wet nights in the short term and six months after the intervention ended.</p><p><strong>Results: </strong>Of 66 participants, 34 were randomized to the IG. The median age was 10.3 years (8.8 - 12), and 53% were male. Intention-to-treat analysis showed a significant reduction in the frequency of wet nights after the interventions (p < 0.001) in both groups, with the IG demonstrating significant improvement, immediately after the interventions (p=0.005) and after six months (p< 0.001) compared to the placebo group (PG). The Kaplan-Meier survival analysis showed improvement in the IG that became more pronounced from the 15th week onwards (log-rank test, p < 0.01).  Conclusions: A 15-week treatment with desmopressin acetate and PTENS significantly reduced wet nights in children and adolescents with PMNE, and this improvement was maintained six months after the interventions.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo Laparoscopic Pyeloplasty in Children: Results from a Multicentric Series.","authors":"Pedro-Jose Lopez, Alejandro Calvillo-Ramirez, Ahmet Sancaktutar, Francisca Yankovic, Juan Manuel Moldes, Juan Pablo Corbetta, Luis Garcia-Aparicio, Luis H Braga, Francisco Reed","doi":"10.1590/S1677-5538.IBJU.2025.0077","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0077","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the experience of five training centers with redo laparoscopic pyeloplasty (RLP) in children with restenosis of the uteropelvic junction (UPJ), assessing whether this approach increased or not postoperative complications or surgery failure.</p><p><strong>Materials and methods: </strong>A retrospective, descriptive study was conducted, including 19 patients who underwent transperitoneal RLP at five independent training centers across 4 different countries between January 2009 and December 2017. All patients had previously undergone Anderson-Hynes dismembered pyeloplasty. Primary outcomes included postoperative complication rates and redo surgery failure.</p><p><strong>Results: </strong>There were 19 RLP out of 744 primary laparoscopic pyeloplasties. Median operative time was 150 minutes (interquartile range [IQR] 126.2-180), extended by 19 minutes when colon mobilization was performed. No cases required conversion to open surgery. A median postoperative analgesic requirement and length of stay of 5 and 4 days, respectively, were recorded. No major complications were reported except a single instance of temporary UPJ stenosis, which was managed with a nephrostomy tube and did not require further surgery. After a median follow-up of 17 months, we achieved a 100% success rate. A significant reduction in renal pelvis dilation was noted, with the median anteroposterior diameter (APD) decreasing from 43 mm preoperatively to 17 mm postoperatively (IQR 10-22).</p><p><strong>Conclusions: </strong>Our findings suggest that RLP remains a feasible approach in the management of restenosis of the UPJ even in such different healthcare settings, providing success rates as high as those described in primary pyeloplasty while maintaining a safety profile.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-stage closure of the small non-growing bladder plate: new insight into the anatomy of exstrophy - Trapezoid interpubic ligament (TIPL).","authors":"Vasily V Nikolaev, Nikita V Demin","doi":"10.1590/S1677-5538.IBJU.2025.0052","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0052","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to examine whether retrovesical fibromuscular structures-specifically the trapezoid interpubic ligament (TIPL)-mechanically restrict the inversion of small, non-growing bladder plates (SNGBP) in bladder exstrophy, and to evaluate bladder growth after one-stage closure with TIPL dissection, including the effect of anticholinergic therapy.</p><p><strong>Materials and methods: </strong>Between 2004 and 2023, 15 patients with SNGBP underwent one-stage bladder closure using a modified surgical approach with TIPL dissection. The TIPL, identified as a fibromuscular structure impeding bladder plate (BP) inversion, was targeted. Postoperative bladder capacity was evaluated based on age at surgery and the use of anticholinergic therapy.</p><p><strong>Results: </strong>The TIPL was identified as the primary mechanical impediment to BP inversion. Its dissection restored tissue compliance, facilitating successful one-stage closure in all patients. In children under three years of age at the time of surgery, the mean annual bladder capacity increased by 17.76 mL. Anticholinergic therapy further enhanced bladder growth.</p><p><strong>Conclusion: </strong>TIPL dissection enables one-stage closure in SNGBP patients who were previously considered unsuitable for this method. Early intervention supports bladder development and favorable functional outcomes. These findings provide novel anatomical insights, warranting further morphological and embryological research to validate the universality of this structure and technique.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing Anesthetic Principles: Telesurgery as the Natural Evolution of Robotic Surgery.","authors":"Giovana Barani, Marcio Covas Moschovas, Belmira Luís, Bruno Gallo, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2025.0247","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0247","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining Methodological Approaches in Pediatric Neurosurgery: Considerations for Future Research.","authors":"Shengyi Chen, Yuekun Fang, Bin Cheng","doi":"10.1590/S1677-5538.IBJU.2025.0167","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0167","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial Embolization versus Robotic Partial Nephrectomy for the Treatment of Renal Angiomyolipomas.","authors":"Idir Ouzaid, Pierre-Etienne Gabriel, Byron Lee, Gauthier Delporte, Philippe Puech, Laurent Lemaitre, Evanguelos Xylinas, Arnauld Villers, Georges-Pascal Haber","doi":"10.1590/S1677-5538.IBJU.2025.0163","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0163","url":null,"abstract":"<p><strong>Objective: </strong>To compare the outcomes of robotic-assisted partial nephrectomy (RALPN) and selective arterial embolization (SAE) for the treatment of sporadic renal angiomyolipoma (AML).</p><p><strong>Patients and methods: </strong>The outcomes of patients who were managed by RALPN (n = 191) or SAE (n = 51) for sporadic renal AML were matched (2:1) using a propensity score for analyses. The primary endpoint was therapeutic success defined as the absence of secondary treatment. Secondary endpoints were post-operative complications and renal function preservation (loss of eGFR at 6 months). Univariate and multivariate logistic regression analyses were used to predict factors associated with re-intervention.</p><p><strong>Results: </strong>Patients baseline characteristics in the matched population (RALP, n=96 vs. SAE, n=48) were balanced. LOS was shorter (mean: 4.2 vs. 3.1 days; p = 0.004) and EBL was lower (327 mL vs. 0 mL, p < 0.0001) in the SAE group. Overall (PN: 15.2% vs. AES: 11.7% p = 0.09) and Clavien-Dindo stratified (p = 0.62) complications were similar in both groups. After a comparable mean follow-up time (33 vs. 40 months, p = 0.63), there was an overall mean loss of eGFR of 7.7±26 mL/min/1.73m2 (p = 0.001). This loss was similar between the two groups (PN: 6.87±26 vs. AES: 11.56±23, p = 0.36). After adjusting for identified confounding factors including tumor size, type of primary intervention (RALPN vs SAE) was the only predictive factor for secondary intervention.</p><p><strong>Conclusion: </strong>RALPN was associated with decreased need for secondary treatment with no increase in morbidity compared with SAE.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted Laparoscopic Ureterocalicostomy (RALUC): How we do it.","authors":"Jens-Uwe Stolzenburg, Doreen Trebst, Theodoros Spinos, Toni Franz, Anja Dietel, Stefan Siemer, Matheus Miranda Paiva, Evangelos Liatsikos, Ho Thi Phuc","doi":"10.1590/S1677-5538.IBJU.2025.0125","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0125","url":null,"abstract":"<p><strong>Purpose: </strong>Ureterocalicostomy refers to the anastomosis of the lower pole calyces with the ureter after excision of the hydronephrotic lower renal pole (1, 2). Indications for ureterocalicostomy include previous failed pyeloplasty, ureteropelvic junction obstruction (UPJO) with anatomical abnormalities, such as intrarenal pelvis or short ureter (3) and proximal ureteral strictures (4). The purpose of this video is to demonstrate the technique of Robotic-Assisted Laparoscopic Ureterocalicostomy (RALUC) in a patient with UPJO and intrarenal pelvis.</p><p><strong>Materials and methods: </strong>Preoperatively, a retrograde ureteropyelography was performed. A transperitoneal approach with the Hassan technique was used, followed by the introduction of four additional DaVinci® trocars. The first step of the procedure is dissection of the retroperitoneum, the proximal ureter and lower part of the kidney including the renal hilum. The proximal ureter is dissected below the stricture. The lower pole artery is selectively bulldogged, and the lower pole of the kidney is resected in a circular manner to get broad based access to the lowest calix. The \"Garland\" suture technique is used to control hemostasis of the lower pole of the kidney. Therefore, a running, \"low tension\", circular suture is performed along the whole renal defect. This provides sufficient parenchymal hemostasis without narrowing the access to the lower calix. The ureter is then spatulated and sutured to the lower calix. The video shows step by step the ureterocalical anastomosis in single knot technique and explains tips and tricks.</p><p><strong>Results: </strong>Total operative time was 114 minutes, while estimated blood loss was 25 mL. The JJ catheter was removed at 40 days postoperatively, while an ultrasound was performed after the JJ removal, showing no hydronephrosis. No intraoperative or postoperative complications were reported. The creatinine count and GFR after JJ removal were 92 μmoL/L and 70 ml/min, respectively. During the last follow-up the patient remained asymptomatic and had a mild chronical dilatation of the caliceal system but no hydronephrosis.</p><p><strong>Conclusions: </strong>This video demonstrates the effectiveness and repeatability of RALUC for reconstructing UPJO in patients with very narrow or intrarenal pelvis. RALUC is a feasible, safe and efficient approach for selected patients requiring reconstruction of the upper urinary tract.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}